As Maricopa County's contract with CIGNA neared its close, the Total Compensation staff realized that it would be difficult to preserve tyhe benefits program that we all currently enjoy. Long term contracts with locked-in prices (like our 5 year deal with CIGNA) had become a thing of the past. Premium increases have averaged more than 20% for HMOs over the past three years, and prescription pricing was driving premiums ever higher.

DRAFTING THE "RFP"
With this in mind, the Total Compensation & Materials Management staff began the process of drafting an "RFP" (a "request for proposals" issued by the Materials Management Department, asking bidders for contract proposals) by seeking input from both employees and management team members. Over the past fall, winter, and spring, Total Compensation's staff reviewed benefits satisfaction survey results from both 2001 and 2002, placed several "quick surveys" on the EBC, and conducted a series of focus groups.

This input, along with other research, indicated that unless Maricopa County's current health insurance plan design was modified, Maricopa County would likely see at least 15% rate increases in 2003 and beyond. Specifically, Maricopa County's plan had to be changed in a way that more actively involved employees in the cost of the health care choices they made — particularly in the area of prescription medications. The RFP design team, comprised of employees from five departments, drafted an RFP around these principles. A draft copy of the RFP was distributed to County management team members for comment. The final RFP was issued by the Materials Management Department in January 2002.

PROPOSAL REVIEW
The RFP elicited proposals from wide range of vendors. Ten employees from eight departments served on a bid evaluation team, which reviewed the pros and cons of each vendors proposal. In the final analysis, the evaluation team recommended that separate vendors be awarded contracts for health insurance, prescription coverage, and behavioral health. (Dental coverage was already subject to a competitive process last year, and thus the vendors will remain the same.)

The final step was for a negotiating team (again made up of employees from several different departments) to finalize negotiations with each of the selected vendors. The negotiating team has reached agreement in principle with three different vendors — CIGNA HealthCare for health insurance, Walgreens Health Initiatives for prescription coverage, and United Behavioral Health for behavioral health coverage. These proposals formed the basis of the recommendation to the Board of Supervisors for MariPlan 2003, Maricopa County's benefits package for the coming year. The package was unanimously approved by the Board on August 19, 2002. Open enrollment is set for October 15th through November 2nd.

CONCLUSION
Maricopa County's goal is to maintain a competitive cost for high quality heath coverage. The proposal represents the team's best effort to find a creative balance between cost and a choice of health care providers and programs. Overall, the proposed package keeps employee premium rate increases to an absolute minumum at the same time as other employers are seeing rates increase over 20%. (See comparison charts to State and City Rate links to the right.) This is, in part because Maricopa County is further increasing its contribution that subsidizes the majority of total health (and dental) insurance costs. (See Employer/Employee cost links to the right.) The other main reason is  a innovative redesign of prescription coverage and co-payments. (For more information on these changes click the "What's New" box to the right.)